I have some questions about pancreatitis…

After using the search button, and reading all of the attached websites, I am curious about diet and pain relief.

The history is that my nine year old (ten in January) has been having severe pain. It has been happening for about two and a half months, and each bout lasts six to twelve hours and occurs every two weeks or so. Usually happens in the evening, and is gone in the morning. While feeling ouchy, she presents with a slightly arched back and slow, tender steps. She looks like she can’t find a comfortable position, and her eyes are glassy. She has normal stool, will take a tasty treat with very little enthusiasm, and will drink if baited but has no real interest. There is no vomiting or salivation.

The first time it happened, I called the vet, and they said they could get her an appointment in two days… As she was feeling fine the day of the appointment, they said that she had probably got into something. No blood work. Next time, pretty much the same deal. It happened a couple more times, with much the same results. Three days ago she was having the pain for the fourth or fifth time, and after being brushed off, fired the vet.

This morning at three, she was fine, and at eight was in pain. I have been very worried about her and with it happening so close together, called up the new vet and told them I was on my way (they said no appointments, I said too bad...). Vet checked her out, (lots of head shaking at the mention of raw fed) and said most likely pancreatitis (was slightly firm upon palpation) or kidney, but because of the raw diet, could also be bleeding intestine or bone blockage.

They pulled blood and have her scheduled for an X-ray on Monday morning (this is also when they will get the blood work back). They sent us home, and now, I am left wondering what to do with her. I will fast her today, but beyond that??? Can I do something for the pain? When I asked for direction, I was told that until they get the blood work back (it is Saturday after all… :mad they don’t know what it is. Nothing about how to help her or, ease her pain. When I suggested fasting, the vet said that was a good idea.

I have visited most of the vet around here over the last ten years, and have not found ONE that I am happy with.

Just to get the obvious out of the way...

If the vet truly suspected pancreatitis, bleeding intestines, or a blockage and sent your dog home...That just horrifies me. :shocked:

My experience with pancreatitis is that it is a gradually-worsening episode that usually results in a dog being hospitalized for a few days, on IV fluid and med therapy, no food by mouth, and daily blood tests. I am not personally aware of coming-and-going pancreatitis that resolves itself on its own but I guess it can happen.

Some dogs have a bout of pancreatitis following a binge on fatty food (dumpster diving)and some dogs are prone to frequent bouts of pancreatitis so their diet needs to be adjusted accordingly.

I think your idea to fast her is a good one. If she seems eager to eat tomorrow I'd offer a very small meal of bland food like boneless cooked chicken breasts and soupy white rice and see how she does with that. Make sure she has plenty of water.

Since you don't know what is going on I'd be very hesitant to give her any OTC pain medication, like aspirin, without a DVMs direction. I guess if this was my dog I'd keep him warm and try to keep him calm and relaxed. Massage, tummy rubs, whatever makes your dog feel good is what I'd try.

If things worsen you need to go to an E-Vet.

The final thing I'll say is that what you're describing sounds very similar to what a client of ours had, particularly the arched back, tender tummy, and lack of appetite. It was also a coming-and-going kind of situation. As I remember it this dog had a real problem with gas...so much so that an x-ray showed this poor dog's gut was painfully full of gas. Gas may not be the issue for your dog but I thought I'd mention it as a less-scary possibility.

I'm sorry you both are going through this...and really sorry you have such a lousy vet.

What breed is this dog? (Certain breeds are prone to chronic pancreatitis: miniature schnauzer and several of the terriers).

Has the dog been on any meds, like tetracycline or a diuretic?

Vomiting happens with over 90% of pancreatitis patients. Weakness is a very common symptom. The pain you mention is fairly common (over 50%), but nowhere near as common as vomiting and weakness. Did the vet ask about that?

Do you know what blood tests are being done? How about urine?

I have to say that I do not understand why the dog was sent home.

X-rays are not particularly successful in diagnosing pancreatitis, I have read, except as part of a spectrum of tests. Ultrasound, which isn't so good at "seeing" a normal pancreas, is much better at seeing abnormalities, IF the operator is very experienced.

http://www.idexx.com/animalhealth/laboratory/speccpl/diagnosticupdate2.jsp
is one pretty good overview of the diagnostic procedures.

Frankly, I would consider asking for a referral to an ultrasound specialist unless you feel confident with whatever this vet tells you on Monday.

Lew Olson has a terrific article on pancreatitis.
http://www.b-naturals.com/newsletter/category/pancreatitis/

She also has a good homemade kidney diet article, too. While there is some overlap between the two, you really need the diagnosis before getting into the homemade diet.

I'd fast the dog too, maybe giving some poached white meat of poultry with no skin or fat tomorrow evening if she is better and hungry.

This is all strictly opinion, and I'm not a health professional professional of any kind.

e.t.a. I had not seen Sarah's post -- I guess I was typing. But yes, I agree with everything she said, too.

Edited by Connie Sutherland (10/04/2008 09:45 PM)
Edit reason: eta

Thanks guys!

Sarah, I too was shocked when she told me to take the dog home, I just feel lost in all of this. She is still in a ton of pain and just looks uncomfortable.

Rox has been on a raw diet, and has had this happen after fasting for a day, after eating a large meal, and after eating a small meal. After eating chicken quarters, lamb, and beef, so there is no consistency. I can say that since the first episode she has had a much less fatty diet, as the first vet thought it was an acute attack of pancreatitis. I would guess that gas is not super likely, as she has not had any change in diet, and she is kept on the lean side. There is no tightness or bloated look to her at all, and nothing comes out either end in that department, just normal bowel movements. Thanks for the less scary thought!

Connie, Rox is a small Rottweiler. About 21” at the shoulder, and 67 lbs.

She has not been on meds for six months (she had a egg size sarcoma on her back removed, and was put on Rimadyl for four days) and no meds for at least the last four years before that.

No vomiting at all (vet did ask), and the weakness she is exhibiting reminds me more of trying to avoid pain than actual weakness.

I don’t know what blood tests are being performed, but I do know she was going to run the tests for the two things (can’t remember their names) that sometimes indicate pancreatitis. The did have me take her out to collect urine.

After reading your past posts on this topic, I now know that an ultrasound is more likely to indicate pancreatitis, but didn’t at the time, and it was not mentioned.

Again, because of your posts, I have now printed out both of Lew Olsens articles for pancreatitis and kidney diets. Thanks!


Any other ideas on what it could be? Any other questions?

I feel lost…

The blood and urine tests should tell you something.

An attack after a day of fasting sure doesn't sound like acute pancreatitis to me. It sounds more like intussusception.

How did you ID the pain location? Does the dog stiffen or whine when you palpate the abdomen?

Are there any kidney disease symptoms?

There has been no identification of exact pain location. She is constantly stiff and does not whine at all while touching/palpating. The vet ruled out spinal pain from a lack of response. The dog just stands there miserably.

When I had her get into the car, for the trips to the vet, she is very slow about climbing in, and gives a sharp whine when getting out, like the impact is painful. She will NOT let me pick her up to move her, with my hand either behind her legs, or in front of them. She goes into major avoidance, and whining, so I place a step down for her to get out in her own time.

The different events/diet variation is what really throws me off. The first attack sort of presented like bloat, but there was no tightness of the abdomen or vomiting, and she would eat and drink if offered small bits. I do regularly fast both dogs, so that was not an unusual event, and while she does get variety, none of it is new to her any more…

What other symptoms should I look for in kidney disease?

And thank you…

Well, I had a good post written and lost it.ugh

I had a dog with these symptoms, including having a bloated look, and it was his spine. It was very difficult to tell anything about what was going on with him by palpation because he kept his abdomen tight and was always goosey along his spine. Xrays of his spine told the tale.

Best of luck,
Debbie

Thanks Debbie.

I just hate seeing her in this much pain...

I appriciate the thought, and we eill see with the X-rays tomorrow.

Good luck Jessica, I hope she gets well fast.

 Quote: JessicaKromer

What other symptoms should I look for in kidney disease?

Well, for a kidney infection, any or all:
Squatting or leg lifting but not urinating; pain when the kidney area is palpitated; lethargy or depression; no appetite; weight loss; blood in urine.